| NPI | 1689034860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2015037584) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015037584) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2019-06-19 |